Apparatus, system and methods for extracorporeal blood processing for selectively cooling the brain relative to the body during hyperthermic treatment or to induce hypothermia of the brain

Abstract

A system, apparatus and methods are provided for extra-corporeal blood treatment, and in particular for establishing and maintaining a neck down differential body temperature, while maintaining near normal brain temperatures, to protect the brain from extended or extreme hypothermia or hyperthermia. A blood treatment apparatus and system is provided for differential control of brain temperature and body temperature below the neck. For example, a first bypass circuit with heat exchanger for brain blood circulation maintains a near normal blood temperature, while a second bypass circuit for below the neck blood circulation provides for thermal treatment to induce a temperature differential, e.g. hyperthermia or hypothermia, relative to brain circulation. Such systems and apparatus have application, for example, for diagnostic and therapeutic treatments using hyperthermia, particularly for treatments of extended duration or at elevated temperatures above 42° C., for example, hyperthermia for treatment of cancer, infectious bacterial or viral diseases.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority from U.S. Provisional Application No. 61 / 164,713 filed Mar. 30, 2009, entitled “Neck Down Induced Hyperthermia with bypass cooling to the brain, for the treatment of Cancer, HIV and other Diseases”, which is incorporated herein by reference.TECHNICAL FIELD

[0002] The invention relates to the field of induced hyperthermia or hypothermia for medical treatment and diagnostic purposes. The invention more particularly relates to bio-medical apparatus, systems and methods for extracorporeal blood processing and for establishing and maintaining an elevated body temperature for hyperthemia treatment of Cancer, HIV and other diseases.BACKGROUND ART

[0003] Normal human body temperature, also known as normothermia or euthermia, depends upon the place in the body at which the measurement is made, and the time of day and level of activity of the person. Different parts of the body have different temperatures. Measurements ...

Examples

experiment b

[0239]

[0240]This experiment is identical to the previous experiment, with one major difference. Here we wanted to keep the cerebral temperature constant. As such, the setpoint temperature of the Carotid Arterial Blood Cooling unit was allowed to vary. The setpoint temperature of the cooling unit was controlled in a loop and was based on the temperature of the venous blood returning from the brain. Our objective was to keep the average cerebral temperature constant at 37.6° C., which corresponds to roughly a venous blood temperature returning from the brain of 37.3° C. A control loop was implemented where if the temperature of the venous blood returning from the brain flowing down the internal jugular was greater than 37.3° C. (prior to passing through the Heating Unit), then temperature of the setpoint temperature of the Carotid Arterial Blood Cooling Unit was decreased by 0.02° C. The update rate was every 2 minutes. Conversely, if the venous blood temperature was below 37.3° C., t...

experiment c

[0244]

[0245]This procedure is designed to expose the patient to two temperature plateaus. The first plateau will be at 44° C. for a period of 4 hours, after which the patients core body temperature will be allowed to drop to 42° C., where it will be maintained until a total of 12 hours have elapsed. The purpose of this profile is to leverage the Step Down phenomena which has been observed clinically during whole body hyperthermia trials, where the cells of cancerous tissue is sensitized to heat by being previously exposed to an elevated temperature.

[0246]Further, an Infra Red Heating system which generates long wavelength IR radiation has been added to the setup. Long wavelength infra red has been found to be well suited for the induction of hyperthermia since this frequency of light penetrates deep into the skins and the heat flux is distributed across a fairly thick layer of tissue, which helps prevent burns. The IR lamps are capable of inducing up to 1000 W of heat to the patient...

experiment d

[0267]

[0268]This experiment is identical to Experiment C with one key exception. Over the coarse of the procedure we decrease the Cerebral temperature by 1° C. During the initial hour the Cerebral temperature is decreased from the initial value of 37.6° C., down to 36.6° C. and it is maintained at this value for the full 12 hour duration. After the 12 hour period, the cerebral temperature is gradually increased back to its normal value of 37.6° C. The cerebral temperature is modified by controlling the temperature of the arterial blood flowing up the internal carotid. The cerebral temperature is monitored like before, by measuring the blood temperature returning from the brain in the internal jugular vein. In this particular experiment, the arterial blood is cooled to a temperature as low as 35.1° C. to achieve the desired cerebral temperature of 36.6° C. It is assume that 10% of the cerebral blood supply is coming form the vertebral arteries, and enters the brain at the core body t...

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority from U.S. Provisional Application No. 61 / 164,713 filed Mar. 30, 2009, entitled “Neck Down Induced Hyperthermia with bypass cooling to the brain, for the treatment of Cancer, HIV and other Diseases”, which is incorporated herein by reference.TECHNICAL FIELD

[0002] The invention relates to the field of induced hyperthermia or hypothermia for medical treatment and diagnostic purposes. The invention more particularly relates to bio-medical apparatus, systems and methods for extracorporeal blood processing and for establishing and maintaining an elevated body temperature for hyperthemia treatment of Cancer, HIV and other diseases.BACKGROUND ART

[0003] Normal human body temperature, also known as normothermia or euthermia, depends upon the place in the body at which the measurement is made, and the time of day and level of activity of the person. Different parts of the body have different temperatures. Measurements ...

Examples

experiment b

[0239]

[0240]This experiment is identical to the previous experiment, with one major difference. Here we wanted to keep the cerebral temperature constant. As such, the setpoint temperature of the Carotid Arterial Blood Cooling unit was allowed to vary. The setpoint temperature of the cooling unit was controlled in a loop and was based on the temperature of the venous blood returning from the brain. Our objective was to keep the average cerebral temperature constant at 37.6° C., which corresponds to roughly a venous blood temperature returning from the brain of 37.3° C. A control loop was implemented where if the temperature of the venous blood returning from the brain flowing down the internal jugular was greater than 37.3° C. (prior to passing through the Heating Unit), then temperature of the setpoint temperature of the Carotid Arterial Blood Cooling Unit was decreased by 0.02° C. The update rate was every 2 minutes. Conversely, if the venous blood temperature was below 37.3° C., t...

experiment c

[0244]

[0245]This procedure is designed to expose the patient to two temperature plateaus. The first plateau will be at 44° C. for a period of 4 hours, after which the patients core body temperature will be allowed to drop to 42° C., where it will be maintained until a total of 12 hours have elapsed. The purpose of this profile is to leverage the Step Down phenomena which has been observed clinically during whole body hyperthermia trials, where the cells of cancerous tissue is sensitized to heat by being previously exposed to an elevated temperature.

[0246]Further, an Infra Red Heating system which generates long wavelength IR radiation has been added to the setup. Long wavelength infra red has been found to be well suited for the induction of hyperthermia since this frequency of light penetrates deep into the skins and the heat flux is distributed across a fairly thick layer of tissue, which helps prevent burns. The IR lamps are capable of inducing up to 1000 W of heat to the patient...

experiment d

[0267]

[0268]This experiment is identical to Experiment C with one key exception. Over the coarse of the procedure we decrease the Cerebral temperature by 1° C. During the initial hour the Cerebral temperature is decreased from the initial value of 37.6° C., down to 36.6° C. and it is maintained at this value for the full 12 hour duration. After the 12 hour period, the cerebral temperature is gradually increased back to its normal value of 37.6° C. The cerebral temperature is modified by controlling the temperature of the arterial blood flowing up the internal carotid. The cerebral temperature is monitored like before, by measuring the blood temperature returning from the brain in the internal jugular vein. In this particular experiment, the arterial blood is cooled to a temperature as low as 35.1° C. to achieve the desired cerebral temperature of 36.6° C. It is assume that 10% of the cerebral blood supply is coming form the vertebral arteries, and enters the brain at the core body t...

Images